Key result
Targeted cardiovascular screening in the Pakistani/Bangladeshi group identified 68.7% of the high-risk population at a cost of £59 per person, compared to 19.2% and £98 in the general population.
Why the study?
Does targeted screening compared to mass screening improve cost-effectiveness for identifying high cardiovascular risk across different ethnic groups?
Cross-Sectional (n=9,407)
Does targeted screening compared to mass screening improve cost-effectiveness for identifying high cardiovascular risk across different ethnic groups?
Cardiovascular screening, whether targeted or universal, is more cost-effective in South Asian ethnic groups than in the general population, highlighting its potential to reduce ethnic health inequalities.
Answers are grounded in this paper and cite their sources.
May improve high-risk detection at lower cost in South Asian groups; leaves open whether targeted screening should replace mass approaches.
OBJECTIVES: To investigate ethnic differences in the cost-effectiveness of targeted and mass screening for high cardiovascular risk. DESIGN: Simulation of two screening strategies (targeted screening of most deprived areas and mass screening) using cross-sectional data from Health Survey for England. SETTING: England. SUBJECTS: 9407 adults aged 40-74 years (493 Black Caribbean, 532 Indian, 516 Pakistani/Bangladeshi, 617 Irish and 7249 general population of whom 6633 were White). MAIN OUTCOME MEASURES: Coverage of high-risk population, number needed to screen to identify one person at high cardiovascular risk and cost-effectiveness of targeted screening, with incremental analysis of expanding targeted to mass screening. RESULTS: Coverage, number needed to screen and cost-effectiveness of targeted screening were better in all ethnic minority groups compared with the White group and general population. Targeted screening would identify 19.2% of high-risk individuals in the general population, and require 4.1 people to be screened to identify one person at high cardiovascular risk at a cost of £98. In the Pakistani/Bangladeshi group, 68.7% of the high-risk population would be identified, and only 2.5 people would need to be screened at a lower cost of £59. In comparison with targeted screening, mass screening was less cost-effective overall but the cost per additional high-risk individual detected was the lowest among the South Asian groups (Indian £130 and Pakistani/Bangladeshi £94). CONCLUSIONS: Irrespective of whether cardiovascular screening is targeted or universal, it is more cost-effective in South Asian ethnic groups than in the general population. Therefore, cardiovascular screening has the potential to reduce ethnic health inequalities.
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Baker et al. (2013) conducted a cross-sectional in High cardiovascular risk (n=9,407). Targeted screening vs. Mass screening was evaluated on Coverage of high-risk population, number needed to screen, and cost-effectiveness. Targeted cardiovascular screening in the Pakistani/Bangladeshi group identified 68.7% of the high-risk population at a cost of £59 per person, compared to 19.2% and £98 in the general population.
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